From the Charles University Faculty of Medicine, Hradec Kralove, Czech Republic.
Johannes Gutenberg-Universität Mainz, Germany.
Pediatr Infect Dis J. 2018 Aug;37(8):823-830. doi: 10.1097/INF.0000000000002109.
To support a fully liquid, diphtheria (D)-tetanus (T)-acellular pertussis (aP)-inactivated poliovirus (IPV)-hepatitis B (HB)-Haemophilus influenzae b (PRP-T) vaccine in Europe using a 2, 3, 4 month primary series and a booster at 11-15 months of age. Phase III, randomized, observer-blind studies in Germany and the Czech Republic. Participants who had not received HB vaccine were randomized to a 2, 3, 4 month primary series of DTaP-IPV-HB-PRP-T (group 1; N = 266) or a reconstituted DTaP-HB-IPV//PRP-T comparator (group 2; N = 263) and a booster of the same vaccine. Pneumococcal vaccine (PCV13) and rotavirus vaccine were coadministered at 2, 3, 4 months, and the booster was coadministered with PCV13. Noninferiority (group 1 versus group 2) was tested postprimary series for seroprotection rates (anti-HB and anti-PRP) and vaccine response rates (anti-pertussis toxin and anti-filamentous hemagglutinin). Safety was assessed by parental reports. Noninferiority was demonstrated with the lower bound of the 95% confidence interval for the difference (group 1 to group 2) being > -10% for each comparison. Primary series immune responses were high for all antigens and similar in each group. Prebooster antibody persistence was good, and there was a strong anamnestic response, both being similar for the investigational and control vaccines. Responses to PCV13 and rotavirus vaccine were similar in each group. There were no safety concerns. These data support the use of the DTaP-IPV-HB-PRP-T vaccine in a 2, 3, 4 month schedule without a birth dose of HB vaccine, with a booster dose in the second year of life administered with routine childhood vaccines.
支持在欧洲使用全液体、白喉(D)-破伤风(T)-无细胞百日咳(aP)-灭活脊髓灰质炎(IPV)-乙型肝炎(HB)-流感嗜血杆菌 b(PRP-T)疫苗,采用 2、3、4 月龄基础免疫程序和 11-15 月龄加强免疫。在德国和捷克共和国进行的 III 期、随机、观察者盲法研究。未接种 HB 疫苗的参与者被随机分配至 2、3、4 月龄 DTaP-IPV-HB-PRP-T 基础免疫程序(第 1 组;N=266)或重新配制的 DTaP-HB-IPV//PRP-T 对照疫苗(第 2 组;N=263),并在 11-15 月龄加强免疫相同疫苗。肺炎球菌疫苗(PCV13)和轮状病毒疫苗在 2、3、4 月龄同时接种,加强免疫与 PCV13 同时接种。主要系列后对血清保护率(抗-HB 和抗-PRP)和疫苗应答率(抗百日咳毒素和抗丝状血凝素)进行非劣效性(第 1 组与第 2 组)检验。通过父母报告评估安全性。对于每一次比较,差异(第 1 组至第 2 组)的 95%置信区间下限都> -10%,证明了非劣效性。所有抗原的基础免疫应答均较高,且在每组中相似。加强免疫前抗体持久性良好,并且存在强烈的回忆反应,这两种反应对于研究疫苗和对照疫苗均相似。每组的 PCV13 和轮状病毒疫苗的应答均相似。没有安全性问题。这些数据支持在 2、3、4 月龄的免疫程序中使用 DTaP-IPV-HB-PRP-T 疫苗,无需出生时接种 HB 疫苗,在第二年的生命中用常规儿童疫苗加强免疫。